Objective <p>This study aims to evaluate the efficacy of intrusion movement of mandibular anterior teeth and the potential influencing factors, and to explore the effect of tooth movement on alveolar bone changes with clear aligners for adult deep-bite correction.</p> Methods <p>Twenty patients, including 74 mandibular incisors and 24 mandibular canines, were selected. Based on the cone-beam computed tomography (CBCT) data and intraoral-scanned dental models, the integrated models before and after treatment were completed and used to measure the actual and predicted movement of crown and root. Then we further observed alveolar bone changes. The multivariate linear regression was used to analyze the potential influencing factors related to intrusion movement and the effect of tooth movement on alveolar bone changes.</p> Results <p>Actual anterior intrusion was less than predicted one (<i>p</i> &lt; 0.01), while actual crown labial movement was greater than predicted one (<i>p</i> &lt; 0.01). Regression analysis showed that the patient’s age, overbite, and predicted intrusion affected actual intrusion movement. The changes in alveolar bone height and thickness were mainly related to the sagittal displacement of tooth.</p> Conclusion <p>The efficacy of achieving mandibular anterior teeth intrusion with Angelalign was limited. However, the degree of actual intrusion was positively correlated with the predicted intrusion, suggesting that increasing the predicted amount (overtreatment) might - in certain patients - enhance the achieved intrusion. Notably, mandibular incisor intrusion was often accompanied by proclination, and the extent of alveolar bone remodeling did not match the degree of tooth movement. Hence, the risk of labial alveolar bone defects increased.</p>